Demidova v North Star Ins. Agency

[*1] Demidova v North Star Ins. Agency 2005 NYSlipOp 50537(U) Decided on April 13, 2005 Appellate Term, Second Department Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431. This opinion is uncorrected and will not be published in the printed Official Reports.

Decided on April 13, 2005
SUPREME COURT OF THE STATE OF NEW YORK
APPELLATE TERM: 2nd and 11th JUDICIAL DISTRICTS
PRESENT: April 13, 2005 SUPREME COURT OF THE STATE OF NEW YORK APPELLATE TERM : 2nd and 11th JUDICIAL DISTRICTS PRESENT : PESCE, P.J., RIOS and BELEN, JJ.
2004-1359 K C

Maria Demidova, Appellant,

against

North Star Insurance Agency, Defendant, -and- INTERNATIONAL MEDICAL GROUP, INC., Respondent.

Appeal by plaintiff from an order of the Civil Court, Kings County (E. Nadelson, J.), entered May 21, 2004, granting the motion by defendant International Medical Group, Inc. to dismiss the complaint as against it.

Order unanimously affirmed without costs.

In this action for breach of a contract of insurance, the court below properly dismissed the complaint as against defendant International Medical Group, Inc. (IMG), a plan and claims administrator acting on behalf of Sirius International Insurance Corporation (Sirius), not a party to the action herein. It is well settled that "[w]here there is a disclosed principal-agent relationship and the contract relates to a matter of the agency, the agent will not be personally bound unless there is clear and explicit evidence of the agent's intention to be personally bound" (Holzer Assocs. v Orta, 250 AD2d 737 [1998]). The parties to the contract of insurance at issue were plaintiff and Sirius, and the certificate of insurance clearly so states. Defendant was not a party to the agreement, and no evidence was introduced that it intended to substitute its own liability for any that Sirius might have to plaintiff. Plaintiff's only claim was that she was [*2]improperly refused reimbursement for certain medical tests, procedures and medications pursuant to the terms of the policy. An insurance administrator or claims adjuster acting at the direction of an insurer cannot be held liable in such circumstances (see e.g. Bardi v Farmers Fire Ins. Co., 260 AD2d 783 [1999]).

Plaintiff's contentions regarding the conduct of the court below are dehors the record and have not been considered upon the appeal.
Decision Date: April 13, 2005